Comorbidities and quality of life of patients diagnosed with schizophrenia, depressive disorder, generalised anxiety disorderand neuropatic pain: COSMOS project
Abstract
Objective: The primary objective of the Cosmos Project (ComorbiditieS in Most Severe Neurology and Psychiatric Indications in the Czech Republic), observation, multicentric and prospective study, was the findings of the frequency of the incidence of comorbidities in patients diagnosed with schizophrenia (SCH), depressive disorder (MDD), generalised anxiety disorder (GAD) and neuropathic pain (NP) in outpatient care, and their changes over the course of 4-6 months. The secondary objective was the monitoring of the subjective quality of life depending on the main and secondary diagnoses.
Methods: The incidence of comorbidities was determined by outpatient doctors, apart from primary and comorbidity disorders further demographic and clinical data were recorded, including current treatment and severity of disease (CGI scale), concurrently patients assessed the quality of their life using Q-les-Q (The Quality of Life Enjoyment and Satisfaction Questionnaire). Results: Some 212 doctors (126 psychiatrists and 86 neurologists) participated in data collection in the first round and 189 in both rounds (89 % from the first round). 3 515 patients were examined in the first round and 3 021 in both rounds.
The highest incidence of psychiatric comorbidities was found in patients with MDD (51 and 53 % in the first and second examination respectively; p < 0.05) and GAD (48 and 50 %), less in patients with SCH (27 and 25 %) and the least among patients with NP (20 % in both visits). The highest incidence of somatic comorbidities was found in patients with NP (86 and 85 %), lower in MDD (62 and 60 %) and GAD (60 and 56 %, p < 0.05), and the least among patients with SCH (50 and 48 %).
Patients with MDD and GAD assessed their quality of life as significantly worse than patients with SCH and NP, the presence of associated mental disorders also reduced the quality of life, whereas the presence of somatic disease did not. Conclusion: The results show numerous incidence of psychiatric and somatic comorbidities in patients with schizophrenia, depression, generalised anxiety disorder and neuropathic pain in outpatient care and their significant impact on the quality of life of patients.